Individual provider Active NPI

Annie Quoc-Thy Nguyen-Lin, M.D.

  • Dermatology Physician
  • Soquel, CA
National Provider Identifier
1962793331
Registry record updated Oct 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
122939 Issued in CA
Practice address
2950 Research Park Dr
Soquel, CA 95073-2000
Phone
(831) 458-5548
NPI assigned
Apr 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 122939 CA Primary

Addresses

Primary practice location

2950 Research Park Dr
Soquel, CA 95073-2000

Mailing address

2350 W El Camino Real FL 2
Mountain View, CA 94040-6203

Other names 1

  • Annie Quoc-Thy Nguyen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181110000322 CA Practitioner - Dermatology 2365796398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Stanford University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

2950 Research Park Dr
Soquel, CA 95073-2000
Phone (831) 458-5548

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1322
Removal or shaving of skin growth35
Skin biopsy298

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
122939CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Oct 8, 2018 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Oct 8, 2018 Accepting new patients
Sutter East Bay Medical Foundation Past Accepting new patients

Locations

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

2350 W El Camino Real
Fl 2
Mountain View, CA 94040
Phone (650) 691-6174

795 El Camino Real
#1112
Palo Alto, CA 94301

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

2128 Soquel Ave
Santa Cruz, CA 95062
Phone (831) 425-0727

2950 Research Park Dr
Soquel, CA 95073
Phone (831) 458-5548

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Interoperability endpoints

  • Direct secure messaging: anguyenlin418799@hisp.ehr.sutterhealth.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1303257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1962793331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 W EL CAMINO REAL FL 2",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940406203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 RESEARCH PARK DR",
            "city": "SOQUEL",
            "state": "CA",
            "postal_code": "950732000",
            "telephone_number": "831-458-5548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN-LIN",
        "first_name": "ANNIE",
        "middle_name": "QUOC-THY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-20",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "122939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNIE",
            "last_name": "NGUYEN",
            "middle_name": "QUOC-THY",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Soquel, CA

Sources for this page

Verify at the official NPI Registry.